Book Reviews

Ketamine: Dreams and Realities by Karl Jansen M.D., Ph.D.

In Karl Jansen’s new book on ketamine, we hear from a wide range of ketamine users who are tromping through the same metaphysical playgrounds that Zoe7 makes his home. Although many of these users make the distinction between their drug experience and their reality (using the key delimiter “it felt like” rather than “IT IS, IT IS!!”), the language in many cases is eerily similar to Zoe7’s fantastic claims. Ketamine is indeed the most science-fiction flavored drug of any drug I’ve ever taken. I’ve experienced preposterous shifts in spacetime and wild roller coaster rides across far flung areas of the universe. I’ve been so far gone into ketamine experiences as to not remember who I originally was or where I originally came from, and only upon slowly coming down was I able to piece my personality back together. I usually describe ketamine in relation to the psychedelics by imagining a continuum of experience, with something like MDMA on one end, and something like DMT on the other, and positing that 2CB, LSD, psilocybin, AMT, etc., all have a place on that continuum, and all share a common substrate of “psychedelic-ness”. Ketamine, on the other hand, as a dissociative anesthetic, is clearly playing by its own set of rules, and somehow manages to trump the psychedelics with its delirious potency. Moreover, ketamine has always seemed to me to have much more of an agenda than any of the psychedelics.

So I must confess to a wide degree of skepticism about ketamine’s value as a metaprogramming agent. I have developed a feeling over the course of my experiences that ketamine is essentially a slippery, hollow place, exciting at first, but lacking potential for insight. I freely admit my opinion is atypical of my circle of friends, and of the many people who populate portions of Jansen’s book. Moreover, I freely admit that undoubtedly some component of my set and setting could easily be at fault, and could easily explain why I view ketamine as more of a cosmic video game than a productive avenue of personal exploration.

It’s not Jansen’s goal to change my mind, however, and that’s part of what wound up appealing to me about the book. Indeed, Ketamine: Dreams and Realities is obviously a very important work, at a time when ketamine use is definitely spreading throughout the underground. Jansen’s tone is relentlessly even-handed, acknowledging dozens of reports of profound spiritual and psychological benefit, but also just as readily acknowledging the risks inherent with regular use of ketamine. Jansen is credited on the book cover as being “the world’s leading expert on ketamine,” and the book covers a wide range of topics, from the history of ketamine, to its use by some rather infamous characters, to some promising work in the psychotherapeutic realm. In places overly dry, in others fascinating and even chilling, the book is the authoritative introduction to the topic of ketamine that the subject has needed for some time.

My own suspicious attitude toward the drug certainly hindered my appreciation of the opening section, “Part I - The Light Within.” Even in my circle of enthusiastic ketamine psychonauts, I have rarely heard such glowing language to describe ketamine as Jansen brings to bear. Indeed, if I had ever personally felt “an ocean of brilliant white light, which is filled with love, bliss, and energy” while on K, I’m sure my take on the subject would be very very different. Jansen presents a catalogue of experience that sounds like a take-out menu for deep metaphysical delight: recovery of forgotten memories, high speed travel through the plumbing of the universe, out of body experiences, lucid dreaming, becoming mythological beings, telepathy/magic/synchronicity, apparent insights into the nature of existence and the self, bonding and love, contact with the “higher self,” and “becoming God.” These experiences are presented uncritically; they are simply reports he has catalogued, offering insight into why people find this drug interesting in the first place. Those who have never experienced K might find all the convincing they need in these trip reports.

But as Jansen progresses, bringing to bear his understanding of the neurochemistry of the experience, we begin to gain some unexpected insights. As a near complete layperson, someone almost willfully ignorant in these matters, I enjoyed and appreciated gaining an understanding of where and how K operates in the brain, and what the potential ramifications are of its activity. In a chapter comparing the ketamine experience to that of the Near Death Experience, Jansen makes a careful argument that by attempting to understand what happens in the brain during an NDE or during a ketamine experience, he is not attempting to reduce these events to brain chemistry and nothing more; rather, that we still live at a point in our understanding of the universe where spirituality and science, seemingly operating on separate wavelengths, may yet still prove to be overtly and obviously linked in ways that will surprise us.

In a chapter called “The Metaphorical Mental Modem,” the book really opens up and for a brief moment manages to entertain some of the wilder notions embodied in the K experience. It’s been a long time since I’ve seen anyone trot out Timothy Leary’s 8-circuit model, for instance, as a possible means of attempting to understand K or psychedelics in general. Jansen actually brushes up against Zoe7’s utilization of the hyperspace theory in quantum physics (or what John Lilly apparently called “Alternity”) as a possible explanation for the strangeness inherent in the ketamine experience. Using quantum as a possible explanation for consciousness is indeed fertile, engaging territory, and those with an interest in this area may appreciate Jansen’s description of how the language of physics is coming closer to psychedelic terminology. This is used to support the notion that at the root of the ketamine experience, we can find answers to some of the basic questions of our reality. For instance, perhaps a membrane in super string theory is analogous to the “membrane” that Lilly describes and that is apparently common among ketamine users. It’s a wild, not entirely convincing chapter, but it’s useful to be reminded that the jury’s still out on such matters.

“Part II – The Dark Side” is a fascinating tour through the morass of ketamine abuse and addiction. Few drugs in the psychedelic community seem at once to be so powerfully rewarding and yet potentially devastating in their effects (MDMA & GHB abuse notwithstanding). The notion that there’s another breakthrough just waiting around the corner, if only the user keeps up a dramatic pace of use, is a common, recurrent theme. In my earliest days of LSD use, I remember encountering this feeling quite often, but because of the way tolerance to LSD builds up, the potential for LSD abuse at that scale in no way approaches the ease with which ketamine can be taken again and again and again over the course of a single sitting, in pursuit of some elusive, delusional goal. Eventually, according to the anecdotes Jansen has accumulated, it becomes clear that there is in fact a kind of tolerance, a gradual diminishing of the core effects that the user initially found so remarkable. Repeated use becomes an attempt to recapture the magic of the user’s initial experiences, and for the most part, it just isn’t possible. I’ve already reached a point where I no longer feel the experience is nearly as exciting as it was initially, and I’ve only tried dissociative doses of ketamine perhaps 30 times… the novelty vanished, and like many of the users in the book, I barely remember what happens on most of these experiences anyway. I can hardly fathom an addictive cycle involving hundreds and hundreds of K trips spent searching for that magic, but clearly it’s a danger, one that should not be underestimated.

The chapters here on addiction, mental health, and physical effects are a valuable summation of the wide range of responses this drug produces. And it never hurts to reiterate harm minimization tactics. The deaths of Marcia Moore and D. M. Turner, and the several near misses John Lilly encountered, are often used to underscore various points in this arena, but those are only the most famous incidents; Jansen has dug up several other deaths that could in some meaningful way be attributed at least in part to ketamine use. As Jansen mentions, good advice offered to novices about keeping a sitter on hand, not trying to move around, not driving a car, and so on, are often ignored by those who are “more experienced,” and that’s where the greatest physical danger may lie with ketamine.

“Part III – Unity” is over all too quickly. In one brief final chapter, we are given a breezy tour of the various psychotherapeutic uses of ketamine that have been attempted or developed, including KPT (Ketamine Psychedelic Therapy) as pioneered by Evgeny Krupitsky, M.D., in St. Petersburg; ketamine’s use in death-rebirth psychotherapy; and others. After reading the book’s harrowing section on “The Dark Side,” I certainly wanted a bit more from Jansen on “Unity.” Clearly I could go dig up all the papers meticulously referenced here, but what I was looking for was a lot more of Jansen’s own take on these therapies. Before I ever picked up the book, the aspect I most wanted information on was the mechanisms of ketamine addiction: was I at risk? Were my friends at risk? How did this happen to people, and how could you make it stop? Jansen gave me a wide range of answers to that question, but this only heightened my curiosity about how in hell could this crazy, slippery, seemingly uncontrollable, regularly delusional miasma of hallucinogenic reverie ever be successfully used in a psychotherapeutic environment? We get a brief look at that via a quick discussion of KPT – illuminating, certainly, if only for a comparison of Russian versus Western methodology – but not nearly enough detail to satisfy me. Indeed, the key thing that was missing here, present throughout the entire rest of the book, was a set of anecdotes in the patients’ own words to describe their experiences. Maybe that material just isn’t available; maybe a future edition could expand this section.

However, the book’s conclusion is a sober, precise look at the unreasonable state of today’s research environment where psychedelics are involved. Coming at the tail end of such a well-researched, carefully muted work, Jansen’s credibility is high as he suggests new approaches. Those steeped in this area will have heard his arguments before, but as he states in his prologue, the target audience for this book includes a wide range of people with no experience or specific understanding when it comes to ketamine – therapists, medical personnel, even perhaps politicians and lawmakers, who may have already come across, or who may soon come across, the phenomenon of ketamine use and abuse as the popularity of the drug begins to swell. The hope is that this book can help stem the potential media backlash that lies in wait for ketamine, more so than has already been leveled at ketamine or psychedelics in general. My guess is the cycle of general antipathy toward psychedelics in general, and ketamine in particular, has a bit further downward to spiral before things get demonstrably better, but Jansen’s book is an important contribution, and may indeed play a part in clearing the air. The book is not in bookstores, but is available from MAPS.